Chapter 1 General Provisions Article 1 (Purpose and Basis) In order to ensure the basic medical needs of employees, in accordance with the "Social Insurance Law of the People's Republic of China" and "Shanghai Municipal Government's Implementation of the Decision of the State Council on Establishing a Basic Medical Insurance System for Urban Employees"

Implementation Plan" and formulate these measures.

Article 2 (Scope of Application) These Measures apply to enterprises, institutions, state agencies, social groups, private non-enterprise units and individual industrial and commercial households with employees (hereinafter collectively referred to as "employing units") and their employees within the administrative region of this city.

Basic medical insurance and related management activities.

Employees as mentioned in these Measures include active employees, retirees and other insured persons.

Article 3 (Relevant Definitions) The outpatient and emergency self-pay section standards as referred to in these Measures refer to the medical expenses incurred by employees for outpatient and emergency treatment in designated medical institutions within one year. According to these Measures, the outpatient and emergency medical expenses shall be included in the funds for payment in the current year.

, the amount borne by the individual employee before payment from the local supplementary medical insurance fund (hereinafter referred to as the "supplementary fund").

The “deductible payment standard from the overall planning fund” as mentioned in these Measures refers to the amount of medical expenses incurred by employees during hospitalization in designated medical institutions or in emergency observation rooms within one year before being paid by the overall planning fund in accordance with these Measures.

The payment ratio of the overall fund and the supplementary fund as mentioned in these Measures refers to the portion of the medical expenses incurred by employees for medical treatment at designated medical institutions within one year that are paid by the overall fund or the supplementary fund in accordance with these Measures.

The maximum payment limit of the overall pool fund as mentioned in these Measures refers to the maximum amount of medical expenses incurred by employees for medical treatment at designated medical institutions within one year, and the maximum amount paid by the pool fund in accordance with these Measures.

Article 4 (Management Department) The Municipal Human Resources and Social Security Bureau is the administrative department in charge of this city’s basic medical insurance and is responsible for the unified management of this city’s basic medical insurance.

District and county medical insurance offices (hereinafter referred to as "district and county medical insurance offices") are responsible for the management of basic medical insurance within their respective jurisdictions.

The municipal development and reform, health and family planning, finance, auditing, food and drug supervision, civil affairs and other departments shall coordinate and manage basic medical insurance in accordance with their respective responsibilities.

This city's social insurance agency is responsible for the collection and payment of basic medical insurance premiums.

The Municipal Medical Insurance Affairs Management Center (hereinafter referred to as the "Municipal Medical Insurance Center") is the city's medical insurance agency, responsible for the settlement and allocation of medical expenses and the management of basic medical insurance personal accounts (hereinafter referred to as the "personal medical accounts").

Article 5 (Adjustment of relevant standards and proportions) The basic medical insurance payment proportion, outpatient and emergency self-payment standards, overall fund minimum payment standards, payment proportions of the overall fund and additional funds, and the maximum payment limit of the overall fund shall be based on the level of basic medical insurance

Adjustments will be made in a timely manner based on the principles of adapting to the city's economic and social development level, maintaining a reasonable gradient of basic medical insurance benefits, and improving the efficiency of the use of medical resources.

The specific adjustment plan will be studied and demonstrated by the Municipal Human Resources and Social Security Bureau in conjunction with relevant departments, and will be announced and implemented after being submitted to the Municipal People's Government for approval.

Chapter 2 Registration and Payment Article 6 (Registration Procedures) The employer shall, in accordance with the regulations of the Municipal Human Resources and Social Security Bureau, handle basic medical insurance registration procedures with the designated social insurance agency.

Among them, newly established employers should go through the basic medical insurance registration procedures within 30 days from the date of establishment.

If the employer terminates in accordance with the law or the basic medical insurance registration items are changed, it shall go through the cancellation or change registration procedures with the original registration agency within 30 days from the date of the relevant circumstances.

When handling the procedures specified in the first two paragraphs of this article, the social insurance agency shall conduct an audit in accordance with the requirements of the Municipal Human Resources and Social Security Bureau, and promptly notify the Municipal Medical Insurance Center of the employer's registration, change of registration or cancellation of registration in accordance with the regulations.

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Article 7 (Calculation method and payment proportion of employee payment base) The payment base of current employees is their average monthly salary in the previous year.

If my average monthly salary in the previous year exceeds 300% of the average monthly salary of employees in the city in the previous year, the excess will not be included in the payment base; if it is lower than 60% of the average monthly salary of employees in the city in the previous year, the excess will not be included in the payment base.

60% of the average monthly salary of active employees in the city is the payment base.

Individual current employees shall pay basic medical insurance premiums at a rate of 2% of their contribution base.

Individual retirees do not pay basic medical insurance premiums.

Article 8 (Calculation method of employer’s payment base and payment proportion) The employer’s payment base is the sum of the payment bases of its employees.

The employer shall pay basic medical insurance premiums at a rate of 9% of its payment base, and pay local additional medical insurance premiums at a rate of 2% of its payment base.

Article 9 (Channels for disbursement of medical insurance premiums) Medical insurance premiums paid by the employer shall be disbursed according to the channels prescribed by the financial department.

Article 10 (Collection and Payment Management) The calculation of the amount of contributions paid by employers and employees, the payment procedures and the handling of collection disputes shall be carried out in accordance with the relevant provisions on the collection and management of social insurance premiums.